With the Kansas City Chiefs having two - count 'em, TWO -- season-ending Achilles injuries in consecutive quarters last Sunday, it's time we learn a little bit more about Achilles. To do this, I spoke with Dr. Ali Mohamadi who is SB Nation's medical correspondent. You'll see him write injury reports with detailed reports on what to expect about the injury, including this one on Achilles injuries. Here's what I learned.
What is Achilles surgery?
"Surgical repair of a ruptured Achilles tendon requires physically suturing the ends of the tendon back together," according to Dr. Ali. "Typically, as the rupture site heals, a small lump remains from the scarring, but this does not impact healing or resumption of physical activity."
What is the treatment like?
"A ruptured Achilles refers to a complete tear through the tendon," Dr. Ali said. "Treatment can be conservative (casting, rest and rehabilitation) or surgical. Some studies show the long-term outcome is similar to surgery with regard to strength and function. However, compared with conservative management, surgery has a lower incidence of re-rupture than nonsurgical treatment and allows a return to pre-injury activities sooner and at a higher level of functioning with less shrinkage of muscle, making it the option of choice for competitive athletes."
Andy Reid said that both Chiefs players would be going with the surgical route.
What is the timeline for their recovery?
Dr. Ali said that most patients are working on their range of motion quickly after surgery and in a cast then an Achilles boot up to eight weeks after surgery. The more strenuous rehab doesn't start until the patient is out of the cast or walking boot. At the four month mark many players would be doing increased activity like jogging followed by running. By six months you're doing everything but it really takes a full year or more before you're back in football shape. There is some atrophy of other muscles due to inactivity during the recovery time. The calf muscle is one of those muscles that players have to work back into form.
What factors go into making a successful recovery?
Dr. Ali told me it comes down to a few things.
1.) Dependent on the player - The player, his work habits, weight, age ... all that stuff about that particular player factors in.
2.) Fitness level before the injury - DJ and Devito were both in good shape.
3.) The course of physical therapy and post-surgical recovery - The rehab process is much more aggressive today than it was 10 years, Dr. Ali said. The results are more favorable these days.
How did Terrell Suggs come back so fast?
He tore his Achilles and was back within five months, which is really fast. The thing is, he only had a partial tear. DJ and DeVito are believed to have full tears (which is what rupture means). A partial tear is obviously easier to come back from than a full tear.
What is the best case scenario?
Back to full strength in six months and participating in offseason workouts as early as next April.
What is the worst case scenario?
That they never play again.
There have been studies (notably a Duke one) that show a certain percentage of players don't come back from Achilles injuries. The problem, as Dr. Ali explained it to me, is that these are outdated by this point. The post-surgery rehab process has improved so greatly even in the past few years that the number of players who return is increasing.
What is a realistic recovery time?
Dr. Ali said that it's reasonable to believe they're both back on the field Week 1 next year. Maybe they're not completely back in football shape but the Achilles should be healthy by that point. Both players have been placed on IR so their 2014 seasons are definitely done. September 2015 is the goal for their return date.